BACKGROUND: The authors report the results of preserving the infrapatellar branch of the saphenous nerve during unicompartmental knee arthroplasty to prevent lateral skin numbness. METHODS: All 100 cases had medial compartmental osteoarthritis and a minimally invasive technique had been used. The mean follow-up duration was two years and eight months (range, 24 to 42 months). RESULTS: The classification according to the location of this nerve was observed as either Mochida Type I with 76 cases (76%), Type II with 16 cases (16%), and unclassified type with 8 cases (8%). In Type I, the nerve was saved in 62 cases (82%), but could not be preserved in Type II because of the surgical procedure. These results showed that the mean distance from the joint line to the nerve of Type I was 9.13 mm (range, 4 to 15 mm) and the nerve passed inferiorly. CONCLUSIONS: This study showed the location of this nerve can be predicted ahead of the procedure, which will help preserve it during the surgery.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects/*methods ; Female ; Humans ; Hypesthesia/etiology/*prevention & control ; *Knee Prosthesis ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Skin/*innervation

Intraneural ganglion of the tibial nerve is very rare. We have experienced a case of the intraneural ganglion cyst in the tibial nerve and medial plantar nerve, which was located at the level of the ankle and foot. A 29-year-old male suffered from lumps causing numbness around the medial aspect of the sole and great toe. But there was no weakness and change of the motor function. We excised the cystic mass successfully and the neurologic symptoms disappeared.
Adult ; Animals ; Ankle ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Male ; Neurologic Manifestations ; Tibial Nerve ; Toes

We report an unusual case of a sigmoid colon perforation after ventriculoperitoneal shunt surgery. Distal catheters are known to cause perforation in the setting of colonoscopy. The exact pathogenesis of this complication is not clear, but it can cause serious complications. Hence, patients require prompt and aggressive management, including laparotomy with bowel wall repair, catheter removal, and antibiotic therapy.
Catheters ; Colon, Sigmoid ; Colonoscopy ; Humans ; Hydrocephalus ; Intestinal Perforation ; Laparotomy ; Ventriculoperitoneal Shunt

It is common to administrate neostigmiae methylsulfate and atropiae aulfate to counteract the effect of nondepolarising neuromuscular blocker. In case of cardiovascular disease, the effect of bradycardia or tachycardia resultiag from the administration of these drugs may be harmful to the patient. The purpose of this study is to investigate the effects of combinatioa and method of administration of neostigmine methylsulfate and atropine sulfate on heart rate. One hundred and two patients in both sexes were devided into three groups(A, B, C), and each group was devided into three subgroups (AI, AII, AIII, BI, BII, BIII, CI, CII, CIII). In group A, neostigmine methylsulfate and atropine aulfate were mixed and administered intravenously within fifteen seconds. In group B, atropine eulfate was administered thirty seconds after the administration of neostigmine methylsulfate. In group C, the two drugs were mixed and administered over a period of five minutes. In subgroup I the ratio of neostigmine methyliulfate to atropine sulfate was 2: 1(0. 04 mg/kg: 0.02 mg/kg) in subgroup 3 the ratio was 3: 2(0.03 mg/kg: 0. 02 mg/kg), and in subgroup lll the ratio was 1: 1(0. 02 mg/kg: 0. 02 mg/kg). The heart rate was counted just before, 0. 5 minute, 1 miaute, l. 5 minutes, 2 minutes, 3 minutes, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 25 minutes, 30 minutes after the administration of the drugs. The results were as follows: 1) Initial increase in heart rate was significant in lager atropine ratio. 2) The later decrease in heart rate waa less in larger atropine ratio. 3) The maximal increases in heart rate in groap A and B appeared thirty seconds apart, but there was little difference betweea them. 4) The change ia heart rate was the least in group C.
Atropine* ; Bradycardia ; Cardiovascular Diseases ; Heart Rate* ; Heart* ; Humans ; Neostigmine ; Neuromuscular Blockade ; Tachycardia

PURPOSE: This study was designed to identify the possible mechanism of insensitivity of DU145 prostate cancer cells to the transforming growth factor (TGF)-beta1-mediated growth inhibition. MATERIALS AND METHODS: DU145 cells were treated with 4, 40, 100 pM TGF-beta1 for 3, 6, 9 days. Initially we performed the growth assay. After that, we analysed the change of cell cycle using fluorescence flow cytometry. At each time point, Western blot analysis with cell pellets was performed to investigate the change of expressions of epidermal growth factor(EGF), TGF-alpha, EGF receptor(EGFR) and TGF receptorII(TbetaR-II) proteins. RESULTS: The growth rate of TGF-beta1-treated cells was initially suppressed, but over time returned to control level. Flow cytometric analysis revealed that TGF-beta1-treated cells showed an increase in apoptotic/G1 phases, and concurrent decrease in S, G2/M phases until 6days. On day 9, however, TGF-beta1-treated cells showed a persistent increase of apoptotic unclei in spite of recovery of apoptotic/G1, S and G2/M phases. Western blot analysis showed that the intensity of EGF or TGF-alpha band decreased in dose-sependent manner on day 6. However, the intensity of each band increased up to the control level on day 9. the expression of EGFR or TbetaR-II protein did not change after treatment of TGF-beta1. CONCLUSIONS: these results suggest that EGF and TGF-alpha sould mediate in part the escape fron the inhibitory effect of TGF-beta1 in DU145 cells.
Blotting, Western ; Cell Cycle ; Epidermal Growth Factor* ; Flow Cytometry ; Fluorescence ; Prostate* ; Prostatic Neoplasms* ; Transforming Growth Factor alpha ; Transforming Growth Factor beta1 ; Transforming Growth Factors ; United Nations

BACKGROUND: Intraoperative collection of bile and a bile culture are of use in predicting bacterial infection in the biliary system. The aim of this study was to identify chronological changes in the bacteriology of the bile in the age and sex distributions for biliary tract disease of the patients. METHODS: We retrospectively reviewed the clinical records of 722 patients who had been operated on for biliary tract disease at the Department of Surgery Ewha Womans University Hospital, from Jan. 1979 to July 1998 and on whom intraoperative bile culture had been performed. We divided the 722 patients into two group based on the time of their treatment, period A being 1979-1988 and period B being 1989-1998. The statistical analysis was done by using the Mantel-Haenszel Chi-Square test. RESULTS: The overall bile culture positive rate was 56% (404 cases), and the male-to-female ratio was 1:1.64. There was no significant statistical difference in the sex ratio between the two periods (period A: 1:1.78, period B: 1:1.55) (p>0.05). Overall, the most commonly isolated organism in the bile was Escherichia coli (137 cases, 30%). Comparing the two periods, we found that the Enterococcus species was an organism found increasingly in biliary tract infections (period A: 0%; period B: 17%) whereas infection by Escherichia coli was significantly decreased in the latter period (period A: 43%; period B: 28%) (p<0.05). The sixth decade (29.1%) was the most prevalent age overall. The age distribution for period A showed no statistical difference between the 5th (21.58%) and the 7th decades (21.94%), but there was significant difference between the 7th (29.95%) and the 5th decades (16.89%) in the age distribution for period B (p<0.05). CONCLUSIONS: According to the above results, we concluded that there were significant chronological changes in the bacteriology of the bile & in the age distributions between the two periods, but no such difference was observed between the sex distribution.
Age Distribution ; Bacterial Infections ; Bacteriology* ; Bile* ; Biliary Tract ; Biliary Tract Diseases ; Enterococcus ; Escherichia coli ; Female ; Humans ; Retrospective Studies ; Sex Distribution ; Sex Ratio

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

Impotence is a common complication of diabetes. 4I diabetic impotent patients were evaluated by audiovisual stimulation penogram. pudendal somatosensory evoked potential (SEP), bulbocavernous reflex latency (BCRL), selective angiogram, erection penogram and nocturnal penile tumescence. This study suggests that neurogenic, vasculogenic and psychogenic abnormalities were prominent etiology in diabetic impotence. Penile prothesis is an adequate treatment for organic impotence and refractory psychogenic impotence.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory ; Humans ; Male ; Penile Erection ; Reflex

No abstract available.
Heart* ; Thoracic Surgery*

Hemorrhagic shock is one of the most common causes of death in patients with multiple trauma and therefore rapid control of bleeding is the main strategy to save these patients. Resuscitative balloon occlusion of the aorta (REBOA) has been applied in several trauma cases and because of the effectiveness of this procedure it has been adopted in the trauma field. Herein, we report the first successful case of REBOA in Korea performed on a 46-year-old man with hemorrhagic shock after a fall from a height of 14-stories. The patient visited our hospital emergency room with hypovolemic shock, we performed Resuscitative Endovascular Balloon Occlusion of the Aorta under bed side blind technique. His vital sign was stabilized after procedure, then we could performed endovascular bleeding control. The patient was discharged on his 33rd in-hospital day without invasive procedure and major scar.
Aorta* ; Balloon Occlusion* ; Cause of Death ; Cicatrix ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Multiple Trauma ; Shock* ; Shock, Hemorrhagic ; Vital Signs